Dry eye disease is a multifactorial, symptomatic condition resulting from a loss of homeostasis in the tear film and/or the ocular surface. The modern understanding of this disease goes far beyond the outdated model of simple tear deficiency. It encompasses tear film instability, hyperosmolarity, epithelial damage, glycocalyx and mucin disorders, eyelid and meibomian gland dysfunction, inflammation, neurosensory abnormalities, and the influence of environmental, iatrogenic, and systemic factors. Of particular significance is the transition from adaptive parainflammation to a chronic, self-perpetuating inflammatory process that exacerbates ocular surface damage and drives disease chronicity. This article reviews current data on the epidemiology, pathophysiology, and immunological background of dry eye disease, as well as the role of the complement system as a potentially overlooked link between innate immunity and chronic ocular surface inflammation. The work also addresses neuropathic pain, comorbidities, iatrogenic factors, and the psychological impact of the disease. It highlights that dry eye disease measurably impairs visual quality, daily functioning, and overall quality of life; therefore, managing dry eye disease remains vital even in patients with other severe, concurrent retinal pathologies. Special emphasis is placed on practical diagnostic and therapeutic implications. Diagnosis requires the presence of both subjective symptoms and objective signs of homeostasis loss. Management should not rely solely on lubrication; instead, it must be tailored to the dominant disease mechanism. This includes tear film stabilization, evaporation protection, anti-inflammatory therapy, eyelid management, mucin and glycocalyx support, and interventions targeting the neurosensory component and comorbidities. The article also discusses the potential value of formulations combining hyaluronic acid, trehalose, and N-acetylaspartylglutamate as an example of a multi-level therapy providing hydration, osmoprotection, and anti-inflammatory benefits. Modern management of dry eye disease should therefore rely on early diagnosis, patient phenotyping, and proactive treatment of the underlying mechanisms driving the disease before it progresses to a severe, chronic, and treatment-resistant form.